Parkinson Disease Clinical Trial
Official title:
Rehabilitation of Postural Abnormalities in Parkinson's Disease: a Single-blind, Randomised Controlled Trial
Verified date | November 2018 |
Source | Universita di Verona |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Postural abnormalities (PA) are drug refractory complications in patients with Parkinson's disease (PD) leading to pain, imbalance, gait disorders and fall-related injuries. It ultimately affects the quality of life and the hospitalisation risk. the literature on treatment outcomes is scant. Rehabilitation is the cornerstone in the management of PD patients, especially for drug-refractory complications. However, the current efforts are only partially able to resolve PA in PD. Despite differences in methodologies, the few rehabilitative studies support the benefits of trunk rehabilitation in PD with PA. Priorities for future research include well-design rehabilitation studies on a large population. The early detection and early rehabilitation of PA might avoid fixed irreversible deformities and reduce the complications that can accompany them. It ultimately might improve the quality of life, reduce the risk of fall-related injuries and hospitalisation rate. A single-blind single-blind Randomised Controlled Trial (RCT) will evaluate the effects of trunk rehabilitation on PA severity, function and disability in outpatients with Parkinson Disease and postural abnormalities.
Status | Active, not recruiting |
Enrollment | 40 |
Est. completion date | November 30, 2018 |
Est. primary completion date | June 1, 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: - Age higher than 18 years old: - A medical diagnosis of PD confirmed according to the Movement disorders criteria; - PS defined as at least 10 degrees of lateral trunk flexion that can be reduced by passive mobilization or supine positioning (PS=10) (Doherty et. al., 2011); - Camptocormia defined as a flexion (at least 5°) in the sagittal plane originating in the thoracolumbar spine, (classified as upper and lower), manifesting during standing and walking and completely subside in recumbent position (Pandey et. al., 2016); - Hoehn & Yahr (H&Y) stage <4 in "ON" medication phase. - Informed consent to participate in the study Exclusion Criteria: - Severe dyskinesia or "on-off" fluctuations; - PD medication modification in the 3 months preceding enrollment into the study; - Need for assistive devices to rise from a chair or bed; somatic sensation deficits involving the legs; - Vestibular disorders or paroxysmal vertigo; other neurological, orthopaedic or cardiovascular co-morbidities |
Country | Name | City | State |
---|---|---|---|
Italy | AOUI Verona | Verona |
Lead Sponsor | Collaborator |
---|---|
Universita di Verona |
Italy,
Bartolo M, Serrao M, Tassorelli C, Don R, Ranavolo A, Draicchio F, Pacchetti C, Buscone S, Perrotta A, Furnari A, Bramanti P, Padua L, Pierelli F, Sandrini G. Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease. Mov Disord. 2010 Feb 15;25(3):325-31. doi: 10.1002/mds.23007. — View Citation
Doherty KM, van de Warrenburg BP, Peralta MC, Silveira-Moriyama L, Azulay JP, Gershanik OS, Bloem BR. Postural deformities in Parkinson's disease. Lancet Neurol. 2011 Jun;10(6):538-49. doi: 10.1016/S1474-4422(11)70067-9. Epub 2011 Apr 22. Review. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Changes in the degrees of trunk deviation in the sagittal and coronal plane. | Changes in the degree of trunk deviation in the sagittal and coronal plane will be assessed using a wall goniometer in standing position. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in Gait speed (cm/sec) | Changes in gait speed will be assessed using the Gait Rite System. It is a computerized walkway providing temporal spatial gait analysis. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in the Percentage Difference of Sway (PDS) | The PDS computed for sway velocity in the eyes open (eo) and eyes closed (ec) conditions. A ratio close to zero or negative indicates that the magnitude of body sway is similar or smaller in the ec than in the eo condition . On the contrary, positive values reflect a larger sway in the ec than in the eo condition. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) | It is a comprehensive assessment designed to monitor the burden and the extent of Parkinson Disease across the longitudinal disease course and provides a clinical end-point in clinical trials. It consists of four sections with a total summed score. Each item have 5 response options (0=normal; 4=severe symptoms/signs). The higher= greater impact of PD symptoms. The Unified Parkinson's Disease Rating Scale - part III (UPDRS III) subscale will be used to measure changes in the motor disability (score range, 0-33; the higher=worse symptoms). |
Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in the Parkinson's Disease Questionnaire (PDQ-8) | The PDQ-8 contains eight of the original 39 items of the PDQ-39; one item selected from each of the 8 scales (mobility, activities of daily living, emotional well-being, stigma, social support, cognitions, communications and bodily discomfort). It provides a reliable measure of overall health status and is ideal for studies in which a shorter questionnaire is preferred. Each question is scored from 0-4 points and the scores are summed. the summed scores are then divided by total possible score and given as a percentage score out of 100 (Score range, 32-100; the higher worse health status) | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | The number of falls | Number of falls occured in the previous month. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in the Mini Balance Evaluation System test (Mini BESTest) | It is a clinical balance assessment tool to target and identify 4 different balance control systems (anticipatory postural adjustments, reactive postural control, sensory orientation, dynamic gait) so that specific rehabilitation approaches can be designed. It is a 14-item test scored on a 3-level ordinal scale (0-2). Total score range 0-32; the higher= better performance. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up | |
Secondary | Changes in the Numeric Pain Rating Scale (NPRS) | A numeric rating scale to measure the amount of pain that a patient feels ranges across a continuum from none (0) to an extreme amount of pain (10). Total score range 0-10; the higher= worse performance. | Pre-treatment, after 5 weeks, at 1 month-follow-up and 4-month follow-up |
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